Our Thinking About Drinking

The Research

Findings on Underage Drinking

Drinking by underage youth is generally considered illegal in most countries and societies. That said, it is also true that at least limited experiences with alcohol are reported by young people and their families around the world. In some societies, young people may be introduced to alcohol at younger ages than in others—typically in the context of family meals or celebrations.ⁱ

Research shows that underage males are more likely to drink than underage females, and also more likely to do so in higher quantities (although some recent studies also show a narrowing of this gender differential).ⁱⁱ In addition, a society’s overall drinking culture has been shown to be a consistently influential factor in determining whether or how young people drink. For instance, in countries such as Greece and Italy with the so-called “Mediterranean” approach to drinking, young people have been found to be more likely to drink, and to drink more often, than their counterparts in other regions, yet also less likely to drink to the point of drunkenness or to display other problematic behaviors associated with excessive drinking. Young people in Scandinavia, on the other hand, have been found to be more likely to drink in a problematic and risky manner.^{iii, iv, v} 

In the United States, according to the U.S. Surgeon General, by age 15, approximately 50 percent of boys and girls have had a whole drink of alcohol; by age 21, approximately 90 percent have done so.^vi

Also in the U.S., the annual Monitoring the Future survey results issued by the National Institute on Drug Abuse reflect that in 2009, the percentage of underage youth who admitted drinking an alcohol beverage in the prior 30-day period were represented as follows: 

• 8th graders—15 percent
• 10th graders—30 percent
• 12th graders—44 percent^vii

In addition, the National Survey on Drug Use and Health (NSDUH) issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) in the U.S. reports that more than one quarter (28.1 percent) of people aged 12 to 20 consumed alcohol in the past month—including:

• 51.1 percent of those aged 18 to 20,
• 25.9 percent of those aged 15 to 17, and
• 6.1 percent of those aged 12 to 14.^viii
  

There is also research which shows that although adolescents drink less frequently than adults, when they do drink, they drink more heavily than adults.^ix In addition, some studies have shown that early initiation of alcohol consumption is associated with higher likelihood of involvement in risky behaviors including driving after drinking, riding with a driver who has been drinking, sexual activity and pregnancy, and interpersonal violence.^{x, xi}

How Underage Youth Make Their Decisions about Whether or Not to Drink

Although there are legal drinking age laws around the world, most young people have some experience with beverage alcohol before they reach the legal drinking age. In addition to culture, other factors have been found to be key influences in shaping young people’s attitudes and approaches toward consuming alcohol. Research also consistently confirms the central role played by parents in influencing their children’s attitudes and behaviors with regard to drinking. According to the 2008 Roper Youth Report, of the individuals between the ages of 8 and 17 surveyed in the U.S., 71 percent identified their parents as the leading influence that might affect their decisions about drinking.^xii

In addition, research surveys reflect that friends and peers play a role in whether young people decide to drink—and if they do decide to drink, their drinking behaviors.^{xiii, xiv} In addition, certain studies have found that young people involved in organized extracurricular activities are less likely to drink in ways that result in negative consequences.^xv However, there are studies which also indicate that young people involved in athletic activities are sometimes more likely to engage in dangerous drinking behaviors.^xvi

Table 1 Youth Survey

Drinking deisions: what youth say...

Among six things that might affect their decisions about drinking. 71% of American Youth (age 13-17) identified their parents as the leading influence.  

Source: GfK Roper YOuth Report. This report was developed from an online survey of 1,008 Americans age 8-17, conducted online March 19, 2008 - April 27, 2008; the data are weighted based on online population estimates from MediaMark‘s (MRI) American Kids and Teens Survey.
*Media includes TV, radio magazines and internet.
In 2008 the respondents could only choose one answer option fo rthis question.
Q.A11: Many times we get ideas for things from what other people say and do. I am going to read a list of some different things and ask which people or things, beside yourself, have influenced you the most in that particular area...wherther you drink alcohol or not.

Young Peoples’ Drinking Behaviors and Patterns

Parental influence and drinking habits have been found to play a very significant role in shaping the drinking behaviors of adolescents and young adults—both positively and negatively.^{xvii, xviii} For instance, one recent study found that even many young children are introduced to alcohol by tasting and sipping in the home—as opposed to having a full drink—most often in a family or religious context, and almost never with friends or when alone. The study reported that in the scientific sample of 452 children aged 8 to 10 interviewed (along with their parents), nearly 40 percent had sipped or tasted alcohol, whereas only six percent had ever had an actual drink.^xix The significant role of parents—and parents’ drinking habits—in influencing how their children drink is emphasized in initiatives such as those developed by DrinkWise and its “Kids Absorb Your Drinking” campaign (see www.drinkwise.com.au), as well as Ireland’s “Is your drinking affecting your thinking” initiative (www.meas.ie).

Family structure can also factor into the development of drinking patterns. For instance, adolescents who have a close relationship with their parents and enjoy a strong sense of family support are reported to be less likely to experience problems associated with drinking than those who lack close family ties and/or adult guidance and supervision.^xx

How Underage Youth Obtain Alcohol

In a June 2008 SAMHSA study, survey results showed than more than 40 percent of underage drinkers in the U.S. were given alcohol for free by an adult age 21 or older. More than half said that they were at someone else’s home when they had their last drink, and more than 30 percent were in their own home.^xxi According to the latest NSDUH report in the U.S., about one in four (26.4 percent) people aged 12 to 20 reported getting alcohol for free from a non-relative of legal drinking age. In addition, 14.6 percent reported getting alcohol for free from an underage peer. Parents and other relatives also play a role in giving alcohol to underage youth, with 8.5 percent reporting that they received alcohol from a relative of legal drinking age, and 5.9 percent receiving it from a parent or guardian.^xxii

A recent survey commissioned by The Century Council asked teens, 'Where do you get the alcohol that you drink?' Sixty-five percent of the underage youth surveyed said that they got the alcohol they drink from family and friends, meaning they got it from their parents, their friends' parents, older siblings or family members or older friends, with or without permission. 

Payment or receipt of alcholol for free for the last use in the past month among alcohol users aged 12 to 20, 2006 & 2007

[anual average percentage, by age group & gender] 
 

Advertising

The relationship between marketing, advertising, and alcohol consumption has been studied using a variety of methodologies. The balance of the evidence does not show a causal relationship between overall alcohol marketing and drinking levels or harmful drinking patterns.^xxiii According to the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA), “When all of the studies are considered, the results of research on the effects of alcohol advertising are mixed and not conclusive.”^xxiv

On the one hand, there is research which shows that parents, and to some extent peers—not advertisements—are the most powerful factor in young peoples’ decisions to drink (and if they do drink, how and to what extent). Moreover, the research tends to show that advertising by alcohol producers largely affects market share for particular brands and substitution between brands. In other words, advertising has not been shown to increase consumption levels, either amongst adults or youth—but rather, has a documented impact on the extent to which certain products and brands are preferred and consumed, versus other products and brands.^xxv

On the other hand, there are recent longitudinal studies which show a modest correlation between advertising and alcohol consumption by underage youth and young adults who are of college age.^xxvi For example, one study found that 12-year olds who are highly exposed to alcohol advertisements are 50 percent more likely to start drinking in a year’s time, compared to youth of the same age who have light exposure to alcohol advertisements.^xxvii The methodologies of these studies have been criticized, and the authors of one study have acknowledged limitations in inferences which can be drawn because “unmeasured confounders cannot be adjusted for and can result in biased findings.”^xxviii

In addition, the research consistently identifies the strong influence of parents and family environment with regard to young peoples’ drinking, as well as peer influence.^xxix

Distinctions: Underage Possession vs. Consumption; On- vs. Off-Premise; ABV levels

Although possession and consumption are closely linked (as consumption requires possession), some jurisdictions distinguish between the two with regard to legal drinking age laws. In addition, some jurisdictions distinguish between possession and consumption in terms of exceptions made to legal drinking age laws.

In the United Kingdom, where the minimum legal age for purchasing alcohol is 18, minors are allowed to consume alcohol in the home from the age of five. In Australia, where the legal age for purchase and possession of beverage alcohol is also 18, children may consume alcohol in the home or under adult supervision at any age. In the U.S., approximately forty states have legislated provisions which specifically allow for consumption under the legal drinking age of 21 under certain circumstances—e.g., for religious reasons and/ or with parental approval.

In addition, certain jurisdictions make distinctions between the legal age limit for on-premise (e.g., pubs, bars, restaurants) versus off-premise (shops, stores, etc.) purchase of alcohol. As a result of such legal distinctions, as well as additional provisions about alcohol content, what is considered to be underage drinking can be a complex matter in some jurisdictions.

For example, in Austria, for distilled spirits, the minimum age for purchase and consumption is 16-years old in three of nine Federal States, and 18-years old in the six other Federal States (with some Federal States differentiating by alcohol content, legislating higher minimum ages for purchase or consumption of drinks with alcohol content of 12 percent Alcohol By Volume (ABV) or more). In Canada, the legal age for consumption or purchase is 18-years old in three provinces, but 19-years old in the remaining provinces. In India, on- and off-premise legal age limits range from 18 to 25, depending on the state. In Belgium, there is no minimum off-premise purchase age for wine and beer; in Brazil, there is no minimum off-premise purchase age for any kind of beverage alcohol.^xxx For more information on such distinctions, see Appendix I and/or the related Issues Forum entry on Legal Drinking Age.

ⁱInternational Center for Alcohol Policies, Blue Book, Module 11. See: http://www.icap.org/PolicyIssues/YoungPeoplesDrinking/tabid/131/Default.aspx.
ⁱⁱInternational Center for Alcohol Policies, Blue Book, Module 11. See: http://www.icap.org/PolicyIssues/YoungPeoplesDrinking/tabid/131/Default.aspx.
ⁱⁱⁱAraoz, G. (2004). Cultural Considerations. In What drives underage drinking? An international analysis. Washington, D.C: International Center for Alcohol Policies.
^ivCurrie, C., Roberts, C., Morgan, A., Smith, R., Settertobutle, W., Samdal, O., et al. (Eds.). (2004). Young people’s health in context. Health Behaviour in School-aged Children (HBSC) study: International report from the 2001/2002 survey. Copenhagen, Denmark: WHO Regional Office for Europe.
^vPopova, S., Rehm, J., Patra, J., Zatonski, W. (2006). Comparing alcohol consumption in Central and Eastern Europe to other European countries, Alcohol & Alcoholism, p.1. See: http://alcalc.oxfordjournals.org/cgi/content/full/agl124v2.
^viThe Surgeon General’s call to Action To Prevent and Reduce Underage Drinking. See: http://www.surgeongeneral.gov/topics/underagedrinking/.
^viiMonitoring the Future, National Results on Adolescent Drug Use (2009), National Institute on Drug Abuse, U.S, Department of Health and Human Services. See: http://www.monitoringthefuture.org/data/09data.html#2009data-drugs.
^viiiUnderage Alcohol Use: Where Do Young People Get Alcohol? National Survey on Drug Use and Health Report (updated November 2008). See: http://www.oas.samhsa.gov/2k8/underageGetAlc/underageGetAlc.htm.
^ixThe Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking. See: http://www.surgeongeneral.gov/topics/underagedrinking/.
^xJ.W. Miller et al, Binge Drinking and Associated Health Risk Behaviors Among High School Students, 119 Pediatrics 76-85 (2007). See: www.pediatrics.org/cgi/content/fall/119/1/76.
^xiOffice of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA), National Survey on Drug Use and Health, March 31, 2008. See: http://www.oas.samhsa.gov/2k8/underage/underage.cfm.
^xiiGfk Roper Youth Report 2008, accessed at http://www.alcoholstats.com/page.aspx?id=135.
^xiiiArata, C. M., Stafford, J., & Tims, M. S. (2003). High school drinking and its consequences. Adolescence, 38, 567–579.
^xivGeckova, A., & van Dijk, J. P. (2001). Peer impact on smoking, alcohol consumption, drug use and sports activities in adolescents. Studia Psychologica, 43, 113–123.
^xvEccles, J. S., & Barber, B. L. (1999). Student council, volunteering, basketball, or marching band: What kind of extracurricular involvement matters? Journal of Youth and Adolescence, 6, 281–294.
^xviLeichliter, J. S., Meilman, P. W., Presley, C. A., & Cashin, J. R. (1998). Alcohol use and related consequences among students with varying levels of involvement in college athletics Journal of American College Health, 46, 257–262.
^xviiDonovan, J. E., Leech, S. L., Zucker, R. A., Loveland-Cherry, C. J., Jester, J. M., Fitzgerald, H. E., et al. (2004). Really underage drinkers: Alcohol use among elementary students. Alcoholism: Clinical and Experimental Research, 28, 341–349.
^xviiiWood, M. D., Read, J. P., Mitchell, R. E., & Brand, N. H. (2004). Do parents still matter? Parent and peer influences on alcohol involvement among recent high school graduates. Psychology of Addictive Behavior, 18, 19–30.
^xixAlcoholism: Clinical & Experimental Research (2008, January 6). Children Are Introduced To Sipping and Tasting Alcohol In The Home. ScienceDaily. See: http://www.sciencedaily.com/releases/2008/01/080103161553.htm.
^xxWood et al., 2004.
^xxiSubstance Abuse and Mental Health Services Administration, June 26, 2008. For a summary and link to full report, see: http://www.samhsa.gov/newsroom/advisories/0806250013.aspx.
^xxiiUnderage Alcohol Use: Where Do Young People Get Alcohol? National Survey on Drug Use and Health Report (November 2008). See: http://www.oas.samhsa.gov/2k8/underageGetAlc/underageGetAlc.htm.
^xxiiiAlcohol Marketing and Young People, International Center for Alcohol Policies. See:http://icap.org/LinkClick.aspx?fileticket=EkpMOGhCHU8=&tabid=243.
^xxivNational Institute on Alcohol Abuse and Alcoholism (NIAAA). (2000). Tenth special report to the U.S. Congress on alcohol and health. Washington, DC: U.S. Department of Health and Human Services.
^xxvInternational Center for Alcohol Policies. See: http://icap.org/PolicyIssues/Marketing/KeyFactsandIssues/tabid/213/Default.aspx.
^xxviAnderson, P., de Bruijn, A., Angus, K., Gordon, R., & Hastings, G. (2009). Impact of alcohol advertising and media exposure on adolescent alcohol use: A systematic review of longitudinal studies. Alcohol and Alcoholism, 44, 229–243. Smith, L. A., & Foxcroft, D. R. (2009). The effect of alcohol advertising, marketing and portrayal on drinking behaviour in young people: Systematic review of prospective cohort studies. BMC Public Health, 9, 15.
^xxviiCollins, R., Ellickson, P., McCaffrey, D., Hambarsoomians, K., 2007. Early adolescent
exposure to alcohol advertising and its relationship to underage drinking. Journal of
Adolescent Health.
^xxviiiAdequate controls for confounding variables are necessary to ensure validity of research results. See: http://www.stap.nl/eucam/home/smith__foxcroft_2007.html. For an overview analysis of the literatures, see: http://icap.org/LinkClick.aspx?fileticket=EkpMOGhCHU8=&tabid=243.
^xxixEpstein, J. A., Griffin, K. W., & Botvin, G. J. (2008). A social Influence model of alcohol use for inner-city adolescents: Family drinking, perceived drinking norms, and perceived social benefits of drinking. Journal of Studies on Alcohol and Drugs, 69, 397–405. Scholte, R. H. J., Poelen, E. A., Willemsen, G., Boomsma, D. I., & Engels, R. C. (2008). Relative risks of adolescent and young adult alcohol use: The role of drinking fathers, mothers, siblings, and friends. Addictive Behaviors, 33, 1–14. van der Zwaluw, C. S., Scholte, R. H. J., Vermulst, A. A., Buitelaar, J. K., Verkes, R. J., & Engels, R. C. M. E. (2008). Parental problem drinking, parenting, and adolescent alcohol use. Journal of Behavioral Medicine, 31, 189–200.
^xxxInternational Center for Alcohol Policies. See: http://www.icap.org/PolicyIssues/YoungPeoplesDrinking/AgeLawsTable/tabid/219/Default.aspx